Zoster incidence in human immunodeficiency virus-infected hemophiliacs and homosexual men, 1984-1997
Zoster incidence in human immunodeficiency virus-infected hemophiliacs and homosexual men, 1984-1997
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DOI：
10.1086/315146
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发表时间：
1999-12-01
影响因子：
6.4
通讯作者：
Biggar, RJ
中科院分区：
文献类型：
--
作者：
Engels, EA;Rosenberg, PS;Biggar, RJ
带状疱疹是人类免疫缺陷病毒 1 型 (HIV) 感染患者的一个重要临床问题。对测试者的危险因素以及 HIV 感染的血友病患者和男同性恋者 (n = 1218) 的发病趋势进行了检查。从 1984 年到 1997 年，共发现了 174 例测试病例（年平均发病率为 2.5%）。先前的测试者发作与后续发作的风险增加相关（相对风险 [RR]，4.30；95% 置信区间 [CI]，3.11-5.95），在血友病患者中，儿童和青少年的测试者风险最高，测试者风险随着年龄的增长而下降（RR，每十年 0.80；95% CI，0.68-0.93），这些研究结果表明 HIV 感染者不会产生或在暴露于水痘测试病毒后保持足够的加强反应。当 CD4 细胞计数 >200 个细胞/mm(3) 时，带状疱疹风险相对稳定，但低于该水平则急剧增加。在 14 年的随访中，测试者的发病率每年下降 9%。尽管 CD4 细胞计数减少，但这种趋势仍然存在，并且无法用齐多夫定或阿昔洛韦的使用来解释。
Zoster is an important clinical problem for human immunodeficiency virus type 1 (HIV)-infected patients. Risk factors for tester and trends in incidence in HIV-infected hemophiliacs and homosexual men (n = 1218) were examined. From 1984 to 1997, 174 tester cases were identified (average yearly incidence, 2.5%). Prior tester episodes were associated with increased risk for a subsequent episode (relative risk [RR], 4.30; 95% confidence interval [CI], 3.11-5.95), Among hemophiliacs, children and adolescents had the highest tester risk, and tester risk declined with age (RR, 0.80 per decade; 95% CI, 0.68-0.93), These findings suggest that HIV-infected persons do not produce or maintain adequate booster responses after varicella tester virus exposure. Zoster risk was relatively constant when CD4 cell counts >200 cells/mm(3) but increased steeply below this level. During the 14 years of follow-up, tester incidence declined 9% per year. This trend occurred despite decreasing CD4 cell counts and was unexplained by zidovudine or acyclovir use.